Description: The Boland-Overberg Region has been characterised by high unemployment (30%) and with insufficient rainfall, the agricultural and related industries have not been able to provide work for new entrants into the job market. When Auxiliary Nursing posts were advertised, these positions could not be filled people because those who did apply did not have the required skills. This led to a crisis in nursing and care at the six district hospitals and at the Eben Dönges Regional Hospital in Worcester.
To address this challenge, representatives from the hospitals met with the Health and Welfare Sector Education Authority (HWSETA) and the Department of Education and established the 18.2 Learnership Project in 1997. All communities were targeted and it was stipulated that 85% had to be black, 54% women and 4% disabled. To reach as many people as possible, advertisements were placed in all towns, community centres and libraries. The minimum requirements were a Grade Eight pass and the ability to read and write in two official languages. The response was so overwhelming that each district hospital short listed possible candidates and, once this was completed, potential beneficiaries were interviewed by a panel comprising hospital staff and community representatives. Candidates who were successful were admitted to a one-year accredited course that included theoretical and practical training that set them on route to become registered nurses. The Human Resource Team from the Eben Dönges Hospital provided theoretical training while practical training was conducted at the district hospital level. To date all participants have passed the course and are working in their respective district hospitals.
Innovation: The partnership formed between the hospitals, the Department of Education, various communities, and HWSETA is an innovative solution to addressing the low skills base in the area and meeting the critical shortage of health personnel. Another innovation is the step-ladder approach to training, whereby workers at the lowest levels (for example, cleaners) can have their skills upgraded.
Effectiveness: Since the inception of the project, 90 community members have completed the learnerships and are employed by the Western Cape Department of Health. Forty cleaners have had their skills upgraded to auxiliary nurses. Thirty-six nurses have completed an additional year of training, while 32 have completed an additional two years of training.
Poverty Impact: All the learners selected for training were unemployed, with the majority of them coming from disadvantaged backgrounds. On completion all earn a salary of R41 946 per annum. Very often they are the only breadwinners and they become role models in their communities.
Sustainability: Funding is secured from the HWSETA and with the critical shortage of health personnel, it seems likely that the project will be funded for at least the next three years. The Hospital Facilitation Board administers the funds received from the HWSETA according to the Public Finance Management Act.
Replication: The model can be replicated in other settings provided management and all other role players are committed. This model also appears to be more successful than other forms of formal nurse training, as it is more practical.